Chronic pancreatitis

Definition

Chronic pancreatitis is inflammation of the pancreas that does not heal or improve, gets worse over time, and leads to permanent damage.

Causes

The pancreas is an organ located behind the stomach that produces chemicals (called enzymes) needed to digest food. It also produces the hormones insulin and glucagon.

When inflammation and scarring of the pancreas occur, the organ is no longer able to make the right amount of these enzymes. As a result, your body may be unable to digest fat and other important parts of food.

Damage to the portions of the pancreas that make insulin may lead to diabetes.

The condition is most often caused by alcohol abuse over many years. Repeat episodes of acute pancreatitis can lead to chronic pancreatitis. Genetics may be a factor in some cases. Sometimes the cause is not known.

Other conditions that have been linked to chronic pancreatitis:

Autoimmune problems (when the immune system attacks the body)

Blockage of the pancreatic duct or the common bile duct, the tubes that drain enzymes from the pancreas

An exploratory laparotomy may be done to confirm the diagnosis, but this is usually done for acute pancreatitis.

Treatment

People with severe pain or who are losing weight may need to stay in the hospital for:

Pain medicines

Fluids given through a vein (IV)

Stopping food or fluid by mouth to limit the activity of the pancreas, and then slowly starting an oral diet

Inserting a tube through the nose or mouth to remove the contents of the stomach (nasogastric suctioning) may sometimes be done. The tube may stay in for 1 - 2 days, or sometimes for 1 - 2 weeks.

Eating the right diet is important for people with chronic pancreatitis. A nutritionist can help you create the best diet to maintain a healthy weight and receive the correct vitamins and minerals. All patients should be:

Drinking plenty of liquids

Eating a low-fat diet

Eating small, frequent meals (this helps reduce digestive symptoms)

Getting enough vitamins and calcium in the diet, or as extra supplements

Limiting caffeine

The doctor may prescribe pancreatic enzymes, which you must take with every meal. The enzymes will help you digest food better and gain weight.

Avoid smoking and drinking alcoholic beverages, even if your pancreatitis is mild.